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Surgery- Trauma

Total questions: 55

Worksheet time: 28mins

Name
Class
Date
1.

What is the leading cause of death in individuals aged 1–45 in the U.S.?

a)

Cardiovascular disease

b)

Trauma

c)

Cancer

d)

Stroke

2.

Trauma causes more deaths than all diseases combined in which group?

a)

Elderly

b)

Infants

c)

Young adults

d)

Middle-aged adults

3.

One-third of traffic-related traumatic mortalities are associated with:

a)

Speeding

b)

Distracted driving

c)

Alcohol use

d)

Mechanical failure

4.

The majority of trauma deaths occur within:

a)

24 hours

b)

12 hours

c)

6 hours

d)

72 hours

5.

What has been shown to reduce trauma-related mortality?

a)

Telemedicine

b)

Trauma systems with evidence-based triage

c)

Paramedic-only response units

d)

Portable X-ray units

6.

Which trauma center designation includes a full spectrum of specialists and 24-hour in-house coverage?

a)

Level I

b)

Level II

c)

Level III

d)

Level IV

7.

Which level provides advanced trauma life support prior to transfer in remote areas?

a)

Level I

b)

Level II

c)

Level III

d)

Level IV

8.

Which of the following differentiates a Level II trauma center from Level I?

a)

No access to neurosurgery

b)

No trauma surgeons

c)

No research or teaching responsibilities

d)

No 24/7 emergency care

9.

Which level center can stabilize and transfer patients but lacks full specialty coverage?

a)

Level II

b)

Level III

c)

Level IV

d)

Level I

10.

What is the main function of trauma system structures?

a)

Minimize diagnostic errors

b)

Shorten ER wait times

c)

Deliver organized care to reduce morbidity and mortality

d)

Provide free trauma education

11.

What is the first step in the trauma primary survey?

a)

Breathing

b)

Circulation

c)

Airway

d)

Exposure

12.

During the "D" step in the trauma survey, what is assessed?

a)

Disability or neurologic function

b)

Diaphoresis

c)

Drug history

d)

Distal pulses

13.

What is the purpose of the secondary survey in trauma?

a)

Immediate airway management

b)

Identify life-threatening injuries

c)

Full head-to-toe exam after stabilization

d)

Provide definitive treatment

14.

Which of the following is a component of the “Exposure” step?

a)

Remove all clothing

b)

Administer naloxone

c)

Start IV fluids

d)

Intubate the patient

15.

Which tool is used during the resuscitation phase to assess internal bleeding?

a)

ECG

b)

Chest X-ray

c)

FAST exam

d)

EGD

16.

What is the most sensitive indicator of moderate hemorrhagic shock?

a)

Hypotension

b)

Diaphoresis

c)

Agitation

d)

Oliguria

17.

What class of hemorrhagic shock involves profound hypotension and anuria?

a)

Class I

b)

Class II

c)

Class III

d)

Class IV

18.

At what class does hypotension typically become apparent in hemorrhagic shock?

a)

Class I

b)

Class II

c)

Class III

d)

Class IV

19.

What fluid is initially used in trauma resuscitation for blood loss?

a)

D5W

b)

Normal saline

c)

Lactated Ringer's

d)

Colloid only

20.

When is transfusion of blood and blood products recommended?

a)

Class I shock

b)

Asymptomatic anemia

c)

Class III–IV hemorrhagic shock

d)

Non-hemorrhagic trauma

21.

Which type of shock presents with warm extremities and hypotension?

a)

Hypovolemic

b)

Neurogenic

c)

Cardiogenic

d)

Septic

22.

Which condition may cause cardiac compressive shock?

a)

Tension pneumothorax

b)

Sepsis

c)

Hypoglycemia

d)

Stroke

23.

What is the treatment of choice for neurogenic shock if hypotension persists after fluids?

a)

Blood transfusion

b)

Atropine

c)

Vasopressors

d)

Mannitol

24.

Which is a sign of cardiac tamponade?

a)

Tachypnea with hyperresonance

b)

Cyanosis and distended neck veins

c)

Flail chest

d)

Absent breath sounds

25.

What is the hallmark of cardiogenic shock in trauma?

a)

Massive hemorrhage

b)

Decreased myocardial contractility

c)

Spinal cord injury

d)

Liver failure

26.

Which of the following injuries is characterized by paradoxical chest wall movement with respiration?

a)

Pulmonary contusion

b)

Tension pneumothorax

c)

Flail chest

d)

Open pneumothorax

27.

What is the immediate treatment for a tension pneumothorax?

a)

Intubation

b)

Chest X-ray

c)

Tube thoracostomy

d)

Needle decompression

28.

A patient with decreased breath sounds and dullness to percussion after a chest injury likely has:

a)

Pneumothorax

b)

Tension pneumothorax

c)

Hemothorax

d)

Pulmonary embolism

29.

What is the definitive treatment for a sucking chest wound?

a)

100% oxygen and observation

b)

Tube thoracostomy alone

c)

Surgical chest wall closure

d)

Chest X-ray and antibiotics

30.

What percentage of pneumothorax cases are associated with concurrent hemothorax?

a)

20%

b)

40%

c)

60%

d)

80%

31.

What triad is classic for cardiac tamponade?

a)

Hypertension, bradycardia, hypoxia

b)

JVD, hypotension, muffled heart sounds

c)

AMS, tachycardia, diaphoresis

d)

Chest pain, nausea, syncope

32.

What is the initial treatment for pericardial tamponade with hemodynamic instability?

a)

Pericardiocentesis

b)

Chest tube

c)

Needle decompression

d)

IV fluids only

33.

Which imaging tool is most useful for detecting blood in the pericardial space?

a)

CXR

b)

ECG

c)

FAST exam

d)

CT abdomen

34.

What is the preferred emergency treatment for penetrating cardiac injury with tamponade?

a)

Chest X-ray

b)

Pericardial window

c)

Thoracotomy

d)

Pericardiocentesis

35.

Which of the following is most likely in blunt cardiac trauma?

a)

Atrial fibrillation

b)

Ventricular septal rupture

c)

Myocardial contusion

d)

Pericardial effusion

36.

What is the most commonly injured organ in blunt abdominal trauma?

a)

Liver

b)

Pancreas

c)

Kidney

d)

Spleen

37.

What is the diagnostic tool of choice for unstable blunt trauma patients with suspected intra-abdominal bleeding?

a)

CT abdomen

b)

Diagnostic peritoneal lavage

c)

Ultrasound FAST exam

d)

MRI

38.

Which solid organ injury often requires embolization in stable patients with signs of bleeding?

a)

Liver

b)

Pancreas

c)

Spleen

d)

Kidney

39.

A failed Pringle maneuver suggests bleeding from which source?

a)

Portal vein

b)

Hepatic vein or IVC

c)

Gallbladder

d)

Common bile duct

40.

What is the initial test when a FAST exam cannot be performed due to body habitus?

a)

MRI

b)

Diagnostic peritoneal lavage

c)

CT

d)

Exploratory laparotomy

41.

A fracture with >2 fragments and extensive soft tissue damage is best classified as:

a)

Oblique

b)

Comminuted

c)

Greenstick

d)

Spiral

42.

Which injury is an orthopedic emergency requiring fasciotomy?

a)

Greenstick fracture

b)

Compartment syndrome

c)

Hip dislocation

d)

Sprained ankle

43.

What is the classic presentation of fat embolism syndrome?

a)

Dyspnea, petechiae, confusion

b)

Hypotension, bradycardia, syncope

c)

Fever, tachycardia, jaundice

d)

Hematuria, flank pain, hypotension

44.

Which fracture is at high risk for avascular necrosis if not reduced quickly?

a)

Ankle fracture

b)

Posterior hip dislocation

c)

Clavicle fracture

d)

Tibial plateau fracture

45.

What type of fracture involves a partial loss of contact between joint surfaces?

a)

Comminuted

b)

Subluxation

c)

Stress

d)

Transverse

46.

Which of the following is the most critical early sign of compartment syndrome?

a)

Pallor

b)

Pulselessness

c)

Poikilothermia

d)

Pain out of proportion

47.

Femur fractures account for what percentage of fat emboli?

a)

20%

b)

40%

c)

60%

d)

80%

48.

What is the appropriate treatment for a patient with confirmed fat embolism and PaO2 < 60 mmHg?

a)

Anticoagulation

b)

Oxygen or intubation

c)

Bronchoscopy

d)

Diuretics

49.

Which factor increases the risk for venous thromboembolism after trauma?

a)

Asthma

b)

Smoking

c)

Weight-bearing

d)

Age > 40

50.

What is a long-term complication of poor fracture healing resulting in functional impairment?

a)

Malunion

b)

Fat embolism

c)

Avascular necrosis

d)

Osteopenia

51.

A GCS score of 8 indicates what severity of brain injury?

a)

Mild

b)

Moderate

c)

Severe

d)

Normal

52.

Which clinical finding suggests spinal cord injury with spinal shock?

a)

Tachycardia and hypertension

b)

Bradycardia and hypotension

c)

JVD and cyanosis

d)

Raccoon eyes

53.

What is the most effective method to reduce intracranial pressure in the acute setting?

a)

IV steroids

b)

Dexamethasone

c)

Hyperventilation

d)

ACE inhibitors

54.

What is the gold standard for ICP monitoring?

a)

CT head

b)

MRI brain

c)

Intraventricular catheter

d)

Bolt monitor

55.

Which spinal cord injury typically requires immediate surgical intervention?

a)

Stable cervical fracture

b)

Complete SCI

c)

Incomplete SCI

d)

Chronic lumbar stenosis